Black Americans still get far fewer operations, tests, medications and other life-saving treatments than whites, despite years of efforts to erase racial disparities in health care and help African Americans live equally long and healthy lives, according to three major studies being published today.

Blacks' health care has started to catch up to whites' in some ways, but blacks remain much less likely to undergo heart bypasses, appendectomies and other common procedures. They receive fewer mammograms and basic tests and drugs for heart disease and diabetes, and they have fallen even further behind whites in controlling those two major killers, according to the first attempts to measure the last decade's efforts to improve equality of care.

Together, the research paints a discouraging picture of the nation's progress in closing the gap for one of the fundamental factors that affect well-being -- health care -- during a period when blacks have made progress in areas such as income and education.

"We have known for 20 years that we have a problem in our health care system: that blacks and whites do not receive equal care. We had hoped all the attention paid to this topic would result in some improvement. What we found is we have not made much progress," said Ashish K. Jha of the Harvard School of Public Health, who led one of the studies published in the New England Journal of Medicine. "This should be a call to action to make the changes needed to make sure people get equal care."